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2/01/2018

27 psychiatrists fail to answer the baseline question: is Donald Trump a moron?

It turns out that the 27 psychiatrists and other experts represented in this collection of essays did not produce any consensus opinion or “assessment” of Donald Trump’s mental health. Instead, they have shared individual perspectives, integrated primarily around the alarm, distress, disgust, angst, fear (and loathing) they all seem to feel in reaction to the President.

To the extent that a unified psychological profile emerges from these essays, the formulation is lacking any comment on the President’s intelligence - a foundational psychodiagnostic measurement. From a clinical perspective, nothing about his behavior should be interpreted without first answering the baseline question: is Donald Trump a moron?

The experts here are silent on the intelligence question.

Psychiatrist David M. Reiss identified “innate, baseline, intellectual/cognitive skills and ability” as one of five areas of concern regarding “the cognitive abilities of a POTUS.” He concluded, however, that no standards exist for measuring the I.Q. of a politician, and therefore, when it comes to this question, differentiating objective opinion “versus politically based propaganda is an insurmountable problem.”

A concern about an appearance of bias did not stop the other essayists from outlining the now-familiar contours of Trump’s personality type and temperament.

The standard observation is that Trump presents with narcissism. In Part 1 (“The Trump Phenomenon”), the authors effectively discuss related personality theory and research, along with the traits, attitudes, beliefs and behaviors typical of this type of character pathology.

The text demonstrates that narcissism is an operative psychological construct, independent of the formal diagnostic (DSM-5.0) criteria. A character “disorder” is rooted in personality style. It is not a psychiatric “illness.”

Criminal forensic psychologists (such as myself) tend to view narcissism and sociopathy as two sides of the same coin. In his essay, psychologist Craig Malkin makes the point that pathological narcissism is derived from a sense of entitlement, a willingness to exploit others, and an impaired sense of empathy - which is what we often say about psychopaths. Psychologist John Gartner notes that in the classic analytic formulation, the narcissistic syndrome includes: antisocial behavior, paranoid traits, grandiosity, and sadism (i.e., aggressively domineering behavior punctuated by “joyful cruelty,” otherwise known as bullying).

While a number of the authors bandied about words that are associated with different forms of mental “illness,” this remains primarily a discussion about character and personality type.

With respect to whether Trump might display mood disorder, Gartner provides a note of caution about overdiagnosis. As he explains, a “hypomanic temperament” (i.e., high energy) is not the same as clinical hypomania and does not necessarily involve a bipolar diathesis. With respect to whether Trump displays any signs of thought disorder (i.e., actual psychosis or “craziness”), psychologist Michael Tansey presented “delusional disorder” as an explanation for why Trump believes so many things that are not true, despite the available evidence.

The failure to provide a baseline intelligence estimate was particularly obvious in Tansey’s essay about delusions and psychosis.

Tansey cites a series of fact-challenged and nonsensical tweets about being wiretapped by Barack Obama as “the most jarring evidence” of Trump’s ostensible psychosis. Critics observed that it was foolish for the President to make such accusations without any proof. Tansey put two and two together and said that the tweets represented “paranoid delusions.”

The interpretation is quite different when I.Q. is factored into the equation. If the tweets were foolish, why not simply conclude that they were produced by a fool? This is a common question in trial competency evaluations: is a defendant exercising bad judgment because mental disorder has deprived them of reason, or are they just being stupid?

The best estimate of any random person’s IQ is the “measure of central tendency” - the norm or the average. To say that someone is above or below average requires additional observations or evidence. Other than his own testimony (e.g., “trust me, I’m like a smart person”), there seems to be no evidence that Trump’s IQ is any greater than the mean.

During the time he has consumed our attention, Trump has provided few, if any, examples of advanced vocabulary development. He has not demonstrated facility in the comprehension of complex social issues, and he has not performed any notable feats of good judgment relative to practical matters. There seems to be no evidence that he is adept at abstract reasoning, or that he is skilled in associational tasks such as the use of metaphor and analogy.

The public record is bereft of any samples of Trump’s written scholarship (aside from a character-limited stream of consciousness). There are no signs of his having any intellectual curiosity and there is no record of his having mastery over any particular body of knowledge. Rather than displaying intellectual discipline, we have seen that his mind is a place where reality is fluid and “alternative facts” are abundant.

In this book, observations about Trump’s intellect (or lack thereof) are conspicuously absent. These authors, like many, are astounded by the President’s attitudes and behavior, and assume that there must be some distinctly psychiatric underlay. But with each example, there is a question they failed to ask: what if he really is just that dumb?

Salesmanship and self promotion are talents well within the reach of many stupid narcissists, as well as sociopaths of average IQ. Success in these endeavors is not evidence of genius. The Presidency, however, does require a thoughtful, reflective, informed and orderly mind. It requires wisdom and intellect far above the norm.

A person of modest intellect might appear to be “a genius” in one context, while looking like quite the “moron” in another. Doubts about Trump’s intellect have been heard enough times from within his inner circle. Perhaps the 27 psychiatrists could have given that a bit more consideration.